Quality of Anticoagulation with Warfarin in Korean Patients with Atrial Fibrillation and Prior Stroke: A Multicenter Retrospective Observational Study
Keun-Sik HONG; Yang-Ki KIM; Hee-Joon BAE; Hyo-Suk NAM; Sun-U KWON; Oh-Young BANG; Jae-Kwan CHA; Byung-Woo YOON; Joung-Ho RHA; Byung-Chul LEE; Jong-Moo PARK; Man-Seok PARK; Jun LEE; Jay-Chol CHOI; Dong-Eog KIM; Kyung-Bok LEE; Tai-Hwan PARK; Ji-Sung LEE; Seong-Eun KIM; Juneyoung LEE.
Journal of Clinical Neurology
; : 273-280, 2017.
Artículo
en Inglés
| WPRIM | ID: wpr-72142
BACKGROUND AND
PURPOSE:
The quality of anticoagulation is critical for ensuring the benefit of warfarin, but this has been less well studied in Korean ischemic stroke patients with atrial fibrillation (AF).METHODS:
This study retrospectively analyzed the data of patients who had an AF-related ischemic stroke and were treated with long-term warfarin therapy in 16 Korean centers. The quality of warfarin therapy was primarily assessed by the time in therapeutic range [TTR; international normalized ratio (INR), 2.0–3.0] and additionally by the proportion of INR values within the therapeutic range.RESULTS:
The long-term warfarin-treated cohort comprised 1,230 patients. They were aged 70.1±9.7 years (mean±SD), 42.5% were female, and their CHA₂DS₂-VASc score was 4.75±1.41. The TTR analysis included 33,941 INR measurements for 27,487 months per patients, 27.6 (SD, 22.4) INR measurements for 22.4 (SD, 12.9) months. The mean TTR of individual patients was 49.1% (95% confidence interval, 47.9–50.3%), and the TTR quartiles were 64.5%. None of the 16 centers achieved a mean TTR of >60%. Of all INR measurements, 44.6% were within the therapeutic range, 41.7% were 3.0.CONCLUSIONS:
In Korean ischemic stroke patients who had AF, the quality of warfarin therapy was low and might be inadequate to effectively prevent recurrent stroke or systemic embolism.
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WPRO
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